Impact of HIV on tuberculosis in Zambia: a cross sectional study.
OBJECTIVE
To examine the contribution of HIV infection to the apparently increasing incidence of tuberculosis in central Africa.


METHODS
Cross sectional study.


METHODS
Outpatient clinic in teaching hospital, Lusaka, Zambia.


METHODS
346 Adult patients with tuberculosis.


RESULTS
Overall, 206 patients (60%; 95% confidence interval 54% to 65%) were positive for HIV: in one or both assays used. The peaks for both tuberculosis and HIV infection were among men aged 25-34 years and women aged 14-24 years. Of patients with confirmed pulmonary tuberculosis, 73/149 (49%; 41% to 57%) were positive for HIV; 67/83 (81%; 70% to 89%) patients with pleural disease and 16/19 (84%; 60% to 97%) patients with pericardial disease were positive. HIV positive patients with positive sputum culture were less likely to have had a positive sputum smear, and their chest x ray films less often showed classic upper zone disease or cavitation. Of 72 patients who fulfilled clinical criteria for AIDS, 17 were negative for HIV.


CONCLUSIONS
The high prevalence of HIV in patients with tuberculosis suggests that an epidemic of reactivating tuberculosis is arising in those who are infected with HIV. The redirection of public health priorities towards tuberculosis would focus on a major treatable and preventable complication of the AIDS epidemic.
Elliott
A M
AM
School of Medicine, University of Zambia, Lusaka.
Luo
N
N
Tembo
G
G
Halwiindi
B
B
Steenbergen
G
G
Machiels
L
L
Pobee
J
J
Nunn
P
P
Hayes
R J
RJ
McAdam
K P
KP
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D015528:HIV Seroprevalence; D006801:Humans; D008297:Male; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology*; D015024:Zambia / Q000453:epidemiology